A modified technique allowing interactive ultrasound-guided three-dimensional transperineal prostate implantation

Richard G. Stock, Nelson N. Stone, Michael F. Wesson, J. Keith DeWyngaert

Research output: Contribution to journalArticlepeer-review

258 Scopus citations

Abstract

Purpose: Ultrsound-guided transperineal prostate implantation is a new technique for performing permanent isotope implants of the prostate. The details of the technique are presented to demonstrate its ability to place radioactive seeds three-dimensionally within the prostate gland to achieve uniform dose distribution without the need for complicated preplanning. Methods and Materials: An accurate measurement of the prostate volume is made using biplanar transrectal ultrasound. The total activity to be implanted is derived from a look-up table based on prostate volume. The basic plan is to implant 60-70% of the total activity in the peripheray of the gland and the remaining activity in the interior of the gland. The ultrasound transducer provides visualization of the prostate through transverse, longitudinal and oblique cuts and allows for accurate placement of implant needles, approximately 1 cm apart. In addition, these needles can be moved through teh prostate under constant visualization, thus allowing for precise seed placement. Results: The setup of the transrectal ultrasound device as well as prostate volume measurements are performed in 10 to 15 min. The actual placement of the needles and seed implantation takes 1 to 1.5 h to perform. Postimplantation dosimetric evaluation is performed using orthogonal x-ray films and 3 mm thick CT slices taken at 3 mm intervals. This evaluation has confirmed accurate seed placement within the prostate gland. Conclusion: Interactive ultrasound guided transperineal prostate implantation is a fast and accurate method of performing permanent radioactive isotope prostate implants.

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume32
Issue number1
DOIs
StatePublished - 30 Apr 1995

Keywords

  • Brachytherapy
  • Prostate cancer
  • Prostate implantation

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